The research will assess therapeutic outcome, neurologic status, and behavioral test performance in consecutive patients who have undergone bilateral stereotaxic anterior cingulotomy for the relief of persistent pain or for the alleviation of severe psychiatric disease. Our purpose is to interview and examine such patients both before and after operation, so that we can evaluate the postoperative findings in relation to the preoperative baseline for each patient. In this way, we shall be able to specify which diagnostic groups are helped by cingulotomy and which are not, and we can document the duration of any palliative effects. The proposed work will also permit us to describe the neurological and behavioral effects of the surgical procedure, whether transient or lasting, in quantitative terms. Specifically, we shall assess the effects of cingulotomy in many by conducting: 1. A long-term follow-up study of therapeutic outcome, comparing the results for different diagnostic groups; 2. A more detailed examination of different spatial capacities; 3. An expanded analysis of late postoperative changes in test performance; 4. An accelerated effort aimed at explaining the association between large numbers of ECT treatments and cognitive impairment; and 5. A wider search for previously undetected deficits. We shall carry out these investigations in parallel by continuing to monitor the first 61 patients in our series and by examining all new patients in whom cingulotomies are performed by the same neurosurgeon who operated upon the others. As in the past, interviews with patients and their relatives, neurological examinations, and behavioral testing will be done pre-and postoperatively at the M.I.T. Clinical Research Center. Lesions will be verified by C.T. scan.